A Paradigm Shift in the role of Hospitals through Community Organising

We propose to utilise community organising as a methodology to build effective relationships between communities and the hospital. This unique approach, could unlock a wealth of talent in our communities, and will provide a structure for meaningful and constructive co-production of health services.

Also:

Sally Gimson

Ralph Critchley

Phoebe Rutherfold

Why are we doing this: In line with the FYFV recommendation that we “engage with communities and citizens in new ways”, this project proposes to utilise community organising as a methodology of developing a more engaged relationship with patients, citizens and staff. Community organising offers the opportunity to build effective relationships between communities and health professionals. This unique approach, could unlock a wealth of talent in our communities, who are willing to volunteer and take responsibility and leadership for the health of their communities as well as providing a structure for meaningful and constructive co-production of health services.

What are we doing: By using the expertise that historically sits inside hospitalsclinicians can work with citizens to play an important role in creating safe and supportive places, fostering resilience and enabling individuals and communities to take more control of their health and their lives. We want to make the balance of power more equal between ‘experts’ and citizens and that active participation and recognition as well as strong relationships will lead to more resilient and healthy communities. NICE guidance endorses community engagement as a strategy for health improvement. We have undertaken some early testing using this methodology in 2017/18 with excellent uptake and feedback which we now want to build into a formal pilot project. The Trust will partner with Citizens UK and its network of civic organisations in North West London, a ready-made network of trusted community partners. The aim is to create and develop more relationships that have an impact on the communities of the trust serves. We will realise this aim by utilising Citizens UK’s five stages of community organising:

1. Build and train teams: through recruiting and training volunteers.

2. Identify Issues: Teams of clinical leads and community champions leading on ‘listening campaigns’ with departments, communities, neighbourhoods to indentify health priorities important to them.

3. The team will do research actions with Health professionals to find realistic solutions to the issues they find.

4. Negotiate: team will co-produce services and community prevention interventions with the Trust’s decision-makers and health stakeholders. Hold an Assembly to tell stories and celebrate the process

5. Evaluate: the teams will evaluate how well they did, and either carry on or move on to the next set of issues

Methodology: Introduce the community organising method of engaging patients and citizens in change. This community organising approach supports health care staff and clinicians in identifying ‘how to involve patients and public’ and ‘what areas to work on’. It would also give a mechanism for enabling citizens to get involved in designing and making improvements. The methodology would also be used in broader engagement work with the voluntary sector, local authorities as part of the STP in North West London

1. Networks: Widening the networks of patients and public who could be involved – helping teams and the organisation to identify ‘who’ to involve and going beyond the ‘usual’ patients and user groups. This would help connect our hospital to the community it serves. We would test various kinds of networks: place-based e.g. an estate (and engage local residents’ associations, faith institutions and GP surgeries) a condition pathway e.g. Diabetes (and engage GP surgeries and faith institutions with large numbers of older members), or a demographic community e.g. Somali mothers (engaging Somali support groups and mosques).

2. ‘Pull’: Bringing a broader perspective around health and well-being through building, training and developing teams interested in health and social determinants of health, thus ensuring that improvement programmes focus on health more broadly and bring the perspectives of others into such improvement programmes.

3. ‘Peoples agenda’:Co-produce a local ‘people’s innovative community-led interventions and tangible solutions that will tackle wider determinants of health.

Underpinning the success of Citizens UK is an organising curriculum based on the practical experience of community organisers over the last seventy years. The curriculum focuses on the concepts, tools, and practices needed by citizens and communities who wish to organise and win changes to local, city-wide and national policies. We believe this curriculum has a crucial role to play in healthcare in creating a culture of continuous improvement.

What are the outputs: This approach is not just about delivering traditional approaches to public involvement; it is about mobilising communities’ existing strengths and developing real and equal partnerships between communities and healthcare professionals with the ultimate aim to co-design services that meet the needs of the citizens they are meant to serve. We aim to:

– Strengthening communities: build on the community capacities to take action together on health. People would come together to identify local health issues, devise solutions and build sustainable social action

-Widen volunteer and peer support: enhance individuals capabilities to provide advice, information and support or organise activities around health and wellbeing.

– Increase collaborations between the communities, Imperial and the local services to redesign pathways and services to meet the needs of the community.

How you can contribute

- Share with us if you had or know of any experience in community organising for Health

- How can we evaluate the intervention

- Comments on our proposal

- Suggest pathway, place, condition to pilot first

- Your support for our project

Reviewer feedback

This is a great project because…

The role of hospitals in community organising is a compelling idea to explore. The proposal is thoughtful with a good range of partners and relevance to other strategic priorities.

By the time of the event we encourage the project team to think more about…

Further engagement with the Q community would strengthen the proposal, along with building more on existing community organising evidence.

Supporters

Amount requested

£30000

Idea themes

Wider determinants of health

Quality improvement

Public health

Person-centred care

Patient experience

Patient and public involvement

Inequalities

Idea locations

England – London (West)

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Comments

Hi. Are you familiar with the multidisciplinary 'Neighbourhood Team' concept? Social Prescribing and Patient Self Management are also a very relevant activities. All three of theses approaches are discussed on this site via two of my ideas. Please let me know if you would like any further information in these areas. Also my B2B idea has a view on public/patient involvement in what is being referred to as QI if that is of any value to your idea. Regards Tom

Really interesting idea. Made me think of how this could benefit our idea on patients with mental health conditions who frequently attend emergency departments. But I'm not sure that the concept of community can be used on such a heterogeneous group. What do you think?

Hi Deon, we met with a brilliant group from Westminster Mind as part of our initial listening campaign. A lot of the discussion around what changes we could make to improve the quality of care we provide were around experiences in A&E. We started to get introduced to other community groups through the Abbey Centre (a charity run community centre in Westminster), being able to tap into existing local networks and groups felt like the right way to start.